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Recombinant vs plasma-derived von Willebrand factor to prevent postpartum hemorrhage in von Willebrand disease
| Content Provider | Scilit |
|---|---|
| Author | Machin, Nicoletta Ragni, Margaret V. |
| Copyright Year | 2020 |
| Description | Von Willebrand disease (VWD) is a congenital bleeding disorder characterized by deficient or defective von Willebrand factor (VWF). Among women with VWD, postpartum hemorrhage (PPH) is common. Treatment options at delivery include plasma-derived VWF (pdVWF) and recombinant VWF (rVWF). However, limited data are available regarding their efficacy. We conducted a retrospective observational study comparing PPH in women with VWD treated at the Hemophilia Center of Western Pennsylvania between 1 February 2017 and 31 January 2018 with either rVWF or pdVWF. We compared postpartum outcomes, including PPH frequency and estimated blood loss (EBL) at delivery. There were a total of 12 deliveries, 7 vaginal and 5 cesarean. At delivery and for 3 days postpartum, 6 women received 80 IU/kg of rVWF and 6 received 80 IU/kg of pdVWF, based on prepregnancy weight, insurance, and/or patient choice. Treatment groups had similar demographics, including median age (32.0 vs 27.0 years; P = .075), bleeding scores (3.0 vs 3.5; P = .734), and prepregnancy body mass index (29.0 vs 29.2 kg/m2; P = .691). PPH occurred in 3 (25.0%) of 12 deliveries, with no difference by treatment group (2 of 6 rVWF vs 1 of 6 pdVWF; P = 1.000) and no difference in EBL by treatment group (685 vs 462 mL; P = .384) or delivery type (vaginal, P = .722 vs cesarean, P = .531). In summary, PPH occurred in one-fourth of the deliveries in women with VWD, despite a higher dose (80 IU/kg) of rVWF or pdVWF. Future trials are needed to develop and assess novel strategies to prevent PPH in VWD. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391151/pdf |
| Ending Page | 3238 |
| Page Count | 5 |
| Starting Page | 3234 |
| DOI | 10.1182/bloodadvances.2020002046 |
| Journal | Blood advances |
| Issue Number | 14 |
| Volume Number | 4 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 2020-07-28 |
| Access Restriction | Open |
| Subject Keyword | Hematology Treatment Efficacy Hemorrhage Prepregnancy Von Willebrand Rvwf Women with Vwd Journal: Blood advances (Vol- 124, Issue- 14) |
| Content Type | Text |
| Resource Type | Article |
